Abstract Background The Plasmodium falciparum multidrug resistance 1 ( Pfmdr1 ) gene is a critical molecular marker of antimalarial drug resistance. Monitoring Pfmdr1 mutations is essential for guiding treatment strategies and preventing the spread of resistant parasites. This study investigated the prevalence and mutational spectrum of the Pfmdr1 gene in P. falciparum clinical isolates from malaria patients in southeastern Nigeria. Methods A total of 180 patients with suspected malaria were recruited. Malaria infection was confirmed by microscopy in 50 cases, and nested PCR targeting the 18 S rRNA gene identified 35 samples positive for P. falciparum . These were subjected to Pfmdr1 gene amplification by PCR, followed by Sanger sequencing. Associations between Pfmdr1 presence and demographic factors were assessed using Chi-square tests. Results Of the participants, 58% were male and 42% female, aged between 3 years and over 35 years. Pfmdr1 was successfully amplified in 10 of the 35 P. falciparum -positive samples (28.57%). Significant associations were observed between Pfmdr1 gene presence and both age (χ²(1) = 6.429, p = 0.011) and gender (χ²(1) = 6.429, p = 0.011). Sequencing revealed multiple rare non-synonymous mutations, notably at codons I301V, I337L, L445K, I448L, and F546I mutations with potential implications for drug transport and resistance alongside others at I538S, V541T, L542Q, V547I, N646I, N650K, and T1152L, indicating high genetic diversity. Conclusions This study reports low prevalence but high mutational diversity of the Pfmdr1 gene among P. falciparum isolates in south eastern Nigeria. The observed age- and gender-related associations suggest potential host–parasite interaction effects. These findings underscore the need for continuous molecular surveillance to track emerging resistance patterns and inform evidence-based antimalarial treatment policies in endemic regions.
Ogugor et al. (Mon,) studied this question.